| Stark Dental, Pc | |
|
15510 Livernois Ave Detroit MI 48238-1343 | |
| (313) 863-2800 | |
| Not Available |
| Full Name | Stark Dental, Pc |
|---|---|
| Speciality | Dentist |
| Location | 15510 Livernois Ave, Detroit, Michigan |
| Authorized Official Name and Position | Donna M Kirchner (CREDENTIALING MANAGER) |
| Authorized Official Contact | 5869150107 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stark Dental, Pc 15510 Livernois Ave Detroit MI 48238-1343 Ph: (313) 863-2800 | Stark Dental, Pc 15510 Livernois Ave Detroit MI 48238-1343 Ph: (313) 863-2800 |
| NPI Number | 1841648987 |
|---|---|
| Provider Enumeration Date | 05/31/2016 |
| Last Update Date | 05/31/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841648987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2901021511 (Michigan) | Primary |
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